Statement of Changes in Beneficial Ownership (4)
18 February 2021 - 08:07AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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APPROVAL
OMB Number: 3235-0287
Estimated average burden
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Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
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1. Name
and Address of Reporting Person * Drape Eric |
2. Issuer Name and Ticker or Trading
Symbol TEVA PHARMACEUTICAL INDUSTRIES LTD [ TEVA
] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Executive VP Global Operations |
(Last)
(First)
(Middle)
C/O TEVA PHARMACEUTICAL INDUSTRIES LTD., 5 BASEL
STREET |
3. Date of Earliest Transaction (MM/DD/YYYY)
2/14/2021
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(Street)
PETACH TIKVA, L3 4951033
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
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1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Ordinary Shares (1) |
2/14/2021 |
|
M |
|
3926 |
A |
(2) |
41651 |
D |
|
Ordinary Shares (1) |
2/16/2021 |
|
S(3) |
|
2079 (4) |
D |
$11.1281 (5) |
39572 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
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1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of derivative Securities Beneficially
Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Restricted Share Units |
(2) |
2/14/2021 |
|
M |
|
|
3926 |
(6) |
(6) |
Ordinary Shares (1) |
3926 |
$0.00 |
0 |
D |
|
Explanation of
Responses: |
(1) |
The Ordinary Shares may be
represented by American Depositary Shares, each of which currently
represents one Ordinary Share. |
(2) |
Each restricted share unit
represents a contingent right to receive, at settlement, one
ordinary share or, at the option of the Human Resources and
Compensation Committee, the cash value of one ordinary
share. |
(3) |
The transaction reported in
this Form 4 was effected pursuant to a Rule 10b5-1 trading plan
adopted by the reporting person. |
(4) |
Represents the number of
shares required to be sold by the reporting person to cover tax
withholding obligations in connection with the vesting of the
restricted share units listed in Table II. |
(5) |
The price reported in Column
4 is a weighted average price. These shares were sold in multiple
transactions at prices ranging from $11.1200 to $11.1300,
inclusive. The reporting person undertakes to provide, upon request
by the SEC staff, the issuer, or any security holder of the issuer,
full information regarding the number of shares sold at each
separate price. |
(6) |
Restricted share units were
granted on February 14, 2017, with 3,926 vesting on each of
February 14, 2020 and February 14, 2021. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Drape Eric
C/O TEVA PHARMACEUTICAL INDUSTRIES LTD.
5 BASEL STREET
PETACH TIKVA, L3 4951033 |
|
|
Executive VP Global Operations |
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Signatures
|
s/ Dov Bergwerk, as attorney-in-fact for Eric
Drape |
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2/17/2021 |
**Signature of Reporting
Person |
Date |